Military Medical Care Helps Wounded Warrior Accomplish Life’s Tasks

Advances in military medical technology are helping one wounded warrior get back to life. Taylor Morris, a Navy Explosive Ordinance Disposal Technician, lost both legs, left arm and right hand in a bomb blast in Afghanistan, May 2012. The Iowa native is undergoing treatment and rigorous physical therapy at Walter Reed National Military Medical Center in Bethesda, Md.

Morris’ story is a common one among the wounded heroes who return home from Afghanistan and Iraq. The military’s health system has had to adapt to accommodate the needs of soldiers with severe injuries. The Warrior Care blog estimates close to 14,000 service members are recovering from the wounds of war every day, with hundreds of thousands battling the invisible wounds of post-traumatic stress disorder.

Morris’ therapy has helped him return to doing even the most mundane of chores, like making breakfast and working on his hand-eye coordination. The love story of Morris and his girlfriend, Danielle Kelly, went viral this week on websites like Buzzfeed and the Huffington Post. There’s even a video of the couple dancing at a friend’s wedding, demonstrating how far he’s come with his therapy.

Surveys Ensure Better-fitting Gear for Soldiers, Marines

By Donna Miles

American Forces Press Service

NATICK, Mass. – When it comes to combat clothing and gear, size matters for the folks at the Natick Soldier Research, Development and Engineering Center here.

It’s not simply a matter of a tailored military appearance, explained Claire C. Gordon, a senior research scientist who specializes in biological anthropometry, the study of body height, weight and size.

“If you go into combat with a chemical protective ensemble or body armor that doesn’t fit, you are at higher risk,” Gordon said. “The mildest thing that could happen is that it will impair your physical performance because it doesn’t fit you well, so your biomechanics are off. The worst thing that can happen is that it can increase your risk of injury.”

Gordon understands the link between military body size and shape and the mission like few others. Everything a soldier wears, carries, flies, drives, rides in, works in and sleeps in depends on anthropometry, she said.

Recognizing its importance, Gordon designed and oversaw a 1988 Army survey that provided a representative sample of the force for the Natick center’s anthropometric database. That database provided the standards used to design everything from military clothing and protective equipment to combat vehicles, aircraft and weapons systems.

It ensured, for example, that the Army was inventorying the correct number of clothing and personal protective items in the correct sizes to accommodate its members.

Buyers for civilian department stores use the same principle, Gordon explained, but with one big exception. “Commercial providers can choose to fit only a subset of the market, or a target market,” she said. “The military has to fit 90 percent of the population right off the shelf, with no customization.” For life-protecting equipment, that percentage increases to as high as 98 percent to support quick-deploying forces, she said.

Yet when the Army started deploying troops to Iraq in 2003, officials were puzzled when they began running low on larger-size chemical-biological protective suits. The Marine Corps ran into a similar predicament with body armor.

As it turned out, ground troops needed larger-size clothing and equipment than expected because they were larger and heavier than the services had realized.

A 2007 Army pilot study conducted at Fort McCoy, Wis., and Fort Hood, Texas, revealed the extent of the problem. Between 1988 and 2007, the average active-duty male soldier was 11 pounds heavier, weighing in at just over 184 pounds. He measured 1.8 inches more around the chest, 2.3 inches more around the waist and 1.6 inches more around the hips.

The smaller sample of active-duty female soldiers in the pilot study showed similar results.

The Army experienced the greatest spike, but Gordon said the phenomenon crosses every military service. “The trend of increasing weight without increasing stature is there – not just in the Army, but also in the Air Force, the Navy and the Marine Corps,” she said.

Gordon cited factors that could have an impact: the military’s changing ethnic composition and a nationwide obesity epidemic, among them. “Compared to the civilian population, we are still lower [in weight],” she said. “But we are in parallel, in terms of the increases we have had.”

Whatever the reasons, Gordon said, it became clear that the Army could no longer depend on data from its 1988 anthropometric study to clothe, protect and equip today’s and tomorrow’s soldiers. As she was laying plans for a new survey, the Marine Corps decided it wanted one for its members, too.

The surveys were conducted using representative samples of each service, with evaluators taking 94 measurements on every participant, as well as three-dimensional whole-body, head-and-face and foot scans, Gordon explained.

In conducting what Gordon called “the most comprehensive anthropometric data set to ever be collected by the Army,” evaluators took measurements of 13,000 soldiers from 57 units at 12 bases in seven states. The survey group included 5,000 soldiers from the active-duty ranks, 2,000 Army reservists, 5,000 National Guardsmen and 1,000 aviators from both active and reserve components.

The Marine Corps survey included almost 2,000 Marines at Quantico, Va., Camp Lejeune, N.C., and Camp Pendleton, Calif. Just under one-third of the participants were female, and, as in the Army study, those selected for the survey were broken down by age, racial and ethnic background and career path to reflect current and future demographic projections.

Both surveys are now completed, with final reports expected within the next six months, Gordon said.

Preliminary conclusions from the Marine Corps survey show that while heights have remained relatively stable for the past two decades, body weight and related body circumferences have increased significantly in both men and women, she reported.

While the body size change in Marines is similar to that in soldiers and U.S. civilians, Marines haven’t experienced the same level of weight gain, she said. Initial findings show that the typical weight increase for male and female Marines was about 3.4 and 3.6 pounds, respectively.

As the final reports are being compiled, data revealed by the surveys already is being incorporated into military programs, reported Cynthia Blackwell, the project leader.

The result, she said, will go a long way toward promoting readiness. “It is critical for service members to have perfectly fitting clothing and gear in order for them to maneuver, move, shoot, communicate and survive,” she added.

It can make the difference, she said, in how they shoulder a weapon or get a site picture on a target, how they and their equipment load into and exit a combat vehicle, and if pilots can properly adjust their seat to ensure safety in a military aircraft.

“So it is not just about having nice-looking clothing,” Blackwell said. “It is for the health and safety and welfare of our service members, and anthropology is a key part of that. It’s foundational in everything we do.”

Grace Under Pressure: A Chaplain Reflects on Suicide Prevention

By Dana McCullough, Health.mil Staff

“Warfighting first.  Be ready to fight and win today, while building the ability to win tomorrow.”  Navy Chief of Chaplains (Rear Adm.) Mark L. Tidd shared this creed in an interview with health.mil to underscore September’s nationwide focus on suicide prevention.

Tidd observed that the same tenets that guide decision-making among seamen of all ranks apply to achieving a state of spiritual and mental well-being.

However, the battlefield of the mind, unlike the combat environment, is a painfully private terrain for some service members.  Some of our country’s bravest men and women struggle with personal demons, perceived failures and seemingly unanswerable life questions that, in the end, leave them desperate.  This is where Tidd and others like him, working closely with service members, their loved ones and medical providers, can step in.

 

 “We’re there, available, and accessible,” Tidd said, adding, “That time becomes an opportunity to have those important conversations…ones that often lead to conversations with family members.”  With a combination of scholarship and humor, the Chaplain explained, “We call that deckplate ministry because we walk the deck plates of the ship.  I call it ‘redeemed loitering’.”

For many, chaplains are known for providing religious services.  Tidd stressed, “The opportunity to practice one’s faith is a readiness issue.  The provision of religious ministry, meeting people’s religious needs is key to helping them toward resiliency.”  He added that, “We [chaplains] care for all, regardless of religious commitment, faith or no commitment.”

Additionally, spiritual counselors can work in tandem with members of the medical community to weigh options for well-rounded approaches to healing.

Tidd characterized the chaplain/physician collaboration as a partnership with the fundamental goal of achieving overall good health for the service member.

Behavioral researchers help Army combat suicides

By David Vergun

DoD Special Correspondent

The desire to "end intense emotional suffering" was among the top factors cited by Soldiers who had at some point attempted suicide, according to researchers from the University of Utah, who interviewed 132 active duty Soldiers Fort Carson, Colo.

While the preliminary findings are informative, they are not altogether unexpected and it is hard to draw conclusions from a relatively small sampling, said Bruce Shahbaz, the Army's special assistant to the director of Health Promotion, Risk Reduction and Suicide Prevention.

So what contributes to "intense emotional suffering?"

"The most reoccurring stressor we've found over the last several years is psychological pain related to a failed relationship," Shahbaz said. He explained that a failed relationship could include anything from marital problems or girlfriend/boyfriend issues, to the loss of a parent or an extremely close friend.

Other contributing factors encompass a range of behavioral health issues, he said, including depression, anxiety disorders, substance abuse and post-traumatic stress disorder.

To help combat these stressors the Wisconsin National Guard has internal programs such as "Strong Bonds," as well as subject matter experts such as Military Family Life Consultants (MFLCs) and a director of psychological health. The Wisconsin National Guard works with local VA Medical Centers and Vet Centers to provide overall support to service members who may find themselves experiencing overwhelming life stressors.

Frequency and duration of deployments have been widely discussed factors in recent years, but Shahbaz said the issue isn't that simple. He said that while deployments have been trending down in the last few years, suicides have been edging up.

Earlier this month, the Army announced that 147 Soldiers died by suicide in the first six months of the year, an average of one every 30 hours. This includes 89 active duty Soldiers, 36 Army National Guard Soldiers not on active duty and 22 Army Reserve Soldiers not on active duty. This is 12 higher than the Army had at the same point last year.

Shahbaz said researchers theorize that, "if you're constantly deployed, training or preparing for redeployment, you are in a 'zone' and you don't try to reintegrate with family and loved ones. But with longer dwell times, problems surface. The family says he's not acting the same, or perhaps a spouse has taken on responsibilities that the Soldier had previously been doing and conflict arises.

"So we cannot say an increase in suicides are 'caused' by deployment, but we can infer that many are 'deployment-related.' It's a subtle but important distinction."

Shahbaz said he thinks that if behavioral interventions had not been in place for the last three years, the rate of suicides would have been significantly higher.

"Unfortunately, we can only measure the number of suicides, not quantify how interventions may have prevented them," Shahbaz said. "We hear, almost daily, about a concerned noncommissioned officer leader who notices a change in a Soldier's behavior and takes action to help that Soldier. Great leaders can make a huge difference each and every day."

"We're taking a comprehensive approach," Shahbaz said. For example, "local law enforcement can point us to certain risk behaviors that could be precursors to suicide, driving at a high rate of speed or DUI for instance, and chaplains have organized retreats for couples having relationship problems and reserve units have financial classes for soldiers whose homes may be underwater and at risk for foreclosure. Pulling from across the Army is a way for us to get in front of the problem."

Shahbaz said there aren't any simple solutions to the suicide problem.

"Our efforts to promote health, reduce risk, and prevent suicides are continuous and relevant across the entire force," said Walter Morales, chief, Army Suicide Prevention Program. "They include programs that target and focus on prevention, resilience, intervention skills, access to behavioral health and many others that contribute to the overall fitness and discipline of our force."

Suicide Prevention Awareness Month, Morales said, will allow for maximum exposure of the resources the Army makes available to Soldiers to prevent suicides and to reinforce a cultural change in Army ranks.

"This cultural change would call for all of us to remain personally committed to providing available resources to support the overall fitness of our peers, battle buddies, co-workers, friends, and family members," Morales said.

The suicide study at Fort Carson is just a start.

Shahbaz said the Army Medical Research and Materiel Command have 26 different ongoing studies involving soldiers and veterans of the active and Reserve Component and their families worldwide.

"Each study is unique, examining different treatments, combinations of therapies and medicines, screenings, interventions, prevention measures and recovery plans," he said.

The largest of the studies underway is STARRS, the Army Study to Assess Risk and Resilience in Service members. That study is conducted by the National Institute of Mental Health in partnership with the Army.

The five-year STARRS study, slated for completion next year, is touted as the largest military study of suicides ever. The study tracks soldiers from basic training through separation. Soldiers, all volunteers, participating in strict confidentiality, are categorized for resilience, biomarkers, background history and various risk factors with the goal of having a better understanding of the causes of suicides, Shahbaz said.

Col. George Glaze, director of the Health Promotion, Risk Reduction Task Force, said it is important to remove the stigma associated with those struggling with suicidal thoughts.

"A cultural change needs to take place," Glaze said. "It's natural for Soldiers to not want to admit they need help."

Glaze said all Soldiers - including officers, noncommissioned officers and below - need to get involved and look out for their fellow Soldiers.

"The sergeant major of the Army, or SMA, is leading the charge," Glaze said. "The SMA himself at one time needed assistance, asked for and got it and worked through the challenges."

Shahbaz emphasized that the most important message to get across to Soldiers, veterans and their families is that help is readily available and that confidentiality is guaranteed when calling the National Suicide Prevention Lifeline toll-free at 1-800-273-8255.

Shahbaz also said that the phone number is for anyone, but that professionals trained in helping service members and their families are on standby to assist. There is also a Military Crisis Line for those deployed or stationed overseas 1-800-273-8255.

Another important source of help, he said, is http://www.suicidepreventionlifeline.org/.